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Validation of an exoskeletal surgical assist suit in an experiment simulating laparoscopic surgery

Kei Aoki1, Hiroshi Kawahira2, Ryota Nakajima3, Yoshihiro Shimomura4, Toshiyuki Natsume5, Satoshi Chiba6, Takeshi Saito7, Hisahiro Matsubara8. 1Artificial Systems Science, Graduate School of Engineering, Chiba University, 2Center for Frontier Medical Engineering, Chiba University, 3Graduate School of Medical and Pharmaceutical Science, Chiba University, 4Design and Science, Graduate of Engineering, Chiba University, 5Funabashi Municipal Medical Center, 6Chiba Cancer Center, 7Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 8Department of Frontier Surgery, Graduate School of Medicine, Chiba University

Introduction: In laparoscopic surgery, surgeons view a monitor to observe conditions within the body cavity while using forceps. This procedure requires them to operate in difficult positions with twisting of the neck and trunk and lifting of the upper arm, which increases physical burden and possible deteriorates performance. We developed an exoskeletal surgical assist suit (SAS) to decrease the surgeon’s physical burden. SAS aims to support the lifting of the upper arm without interfering with procedures or the use of forceps. To verify the validity of SAS, we conducted experiments simulating laparoscopic surgery (ex vivo experiment) using an electromyogram and measured work efficiency.

Methods: The participants were 4 surgeons skilled in laparoscopic surgery. They performed a continuous suture on a swine stomach transected in the middle using a dry box. An electromyogram was obtained thrice for 30 min on anterior and medial parts of both deltoid muscles, during the procedure performed with and without SAS. Muscle burden, as measured by the electromyogram, was quantified as % maximum voluntary contraction (MVC). The number of sutures inserted within a defined experimental time was defined as work efficiency. Analysis and comparison was made between procedures performed with and without SAS.

Results: The average %MVC on the right anterior part, which had the highest burden in this experiment, was compared between the procedures performed with and without SAS. The %MVC was reduced to 18% from 29% and to 16% from 22% on the parts of anterior and medial deltoid muscles, respectively. On average, the number of inserted sutures was 17 without SAS and 24 with SAS.

Conclusion: In this experiment, the muscle burden on the upper arm was reduced using SAS. Thus, we confirmed the validity of SAS in aiding the surgeon during laparoscopic surgery. In addition, the number of inserted sutures increased, confirming that work efficiency improved.

Outlook: In this experiment, we confirmed the validity of SAS in an experiment simulating laparoscopic surgery. We will further improve SAS to optimize weight saving and switch operation so that it can be used in normal practice for surgery in the future.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 79254

Program Number: P668

Presentation Session: Poster (Non CME)

Presentation Type: Poster

85

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